Der intraossäre Zugang[1]

Zusammenfassung

Seit zwei Jahren bewertet das European Resuscitation Council (ERC) die Applikationsmöglichkeiten für Medikamente bei der kardiopulmonalen Reanimation neu: Mittlerweile gilt der intraossäre Zugang auch beim Erwachsenen als erste Alternative [1], sofern kein intravenöser Zugang hergestellt werden kann. Für Kinder gilt dies in Notfallsituationen bereits seit Jahren - der intraossäre Zugang wird als schnelle, sichere und effektive Route der Medikamentenapplikation eingestuft [2]. Dieser Beitrag erläutert vor dem Hintergrund der aktuellen Empfehlungen die Besonderheiten bei der Etablierung intraossärer Zugänge. Zudem diskutiert er den Stellenwert dieser Applikationsform für die Notfallmedizin.

Abstract

As alternative for drug administration, the intraosseous access is an important option in emergency medicine. Plasma concentrations of drugs, safety and rapidity as well as rate of complications are comparable to the intravenous access. These findings are reflected in the recent resuscitation guidelines, which recommend intraosseous access as an alternative to intravenous access both in children and adults, considering the tracheal route as backup only if the other two options fail. Rescuers should learn safe techniques of establishing an intraosseous access. Equipment of rescue vehicles with adequate devices for children and adults should be considered standard.

Schlüsselwörter

Notfallmedizin - Gefäßzugang - intraossärer Zugang - Medikamente - Reanimation

Key words

emergency medicine - vascular access - intraosseous cannulation - drugs - resuscitation

1 Nachdruck aus: Anästhesiol Intensivmed Notfallmed Schmerzther 2007; 42 (7/8): 494 - 499

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1 Nachdruck aus: Anästhesiol Intensivmed Notfallmed Schmerzther 2007; 42 (7/8): 494 - 499